7 things your dentist wants you to know

photo of a mature woman pointing to her smile with both hands

Instead of putting your money where your mouth is, try putting your health where your mouth is. (Hint: it's already there.)

There's growing recognition we can't ignore our mouths and expect a healthy body. About 300 diseases and conditions are linked in some way to oral health — triggering some problems and worsening others, says Dr. Brittany Seymour, an associate professor of oral health policy and epidemiology at the Harvard School of Dental Medicine.

A nationally representative 2017 poll of more than 2,100 people ages 50 to 64 found that more than one-third had dental problems that caused them to miss work or suffer with pain, difficulty eating, or other health problems within the prior two years. About two-thirds had undergone a dental check-up in the past year, but nearly one-quarter hadn't sought preventive dental care in at least three years.

"There's still a myth that we can neglect our oral health and it only affects our mouths. We know that's not the case," says Dr. Seymour, also a national spokesperson for the American Dental Association. "There's still a lack of awareness around the importance of oral health far beyond the way we look."

Gum disease dangers

Downstream effects of poor oral health can indeed prove more serious than the occasional cavity. Harmful bacteria and inflammation can creep from the mouth to the bloodstream and reach far-flung areas of the body.

The heart is particularly vulnerable. Building on research indicating that people with poor oral health (such as gum disease or tooth loss) have higher rates of heart attacks, a new study goes one step further. The analysis, published Aug. 1, 2022, in The Journal of the American Dental Association, found that heart attack patients who'd had no dental care over the prior year remained in the hospital longer than similar patients who'd had dental treatment.

Meanwhile, a 2020 study in the journal Diabetes Care estimated that among people with diabetes who also had periodontitis (severe inflammation of the gums and the bones that support the teeth), improved gum care could reduce complications such as kidney, nerve, and eye damage by about 20%. Periodontitis is three times more common among people with diabetes, Dr. Seymour says. In addition, a person with uncontrolled gum disease typically has more difficulty controlling blood sugar levels.

"Early warning signs of diabetes can even show up in the mouth," she says. "These include dry mouth, gum disease, changes in taste, slower healing of cuts or sores in the mouth, and mouth infections such as thrush."

Oral care products: What do you really need?

Choosing toothpaste, mouthwash, and other oral care products was once a fairly simple task. But the variety of products vying for our mouths — and wallets — has exploded into a $49 billion oral care market that's expected to nearly double by 2030.

Today's products don't just promise to keep our mouths minty clean and fresh, however. From gum repair toothpaste to plaque removal mouthwash, these items — filling entire aisles of supermarkets and drugstores — make claims that can confuse and frustrate us, says Dr. Brittany Seymour, an associate professor of oral health policy and epidemiology at Harvard's School of Dental Medicine. "Options are a great thing until choosing becomes overwhelming and people aren't confident in the choices they're making," she says.

It's smart to be skeptical. Removing plaque, for example, requires some kind of mechanical process, such as brushing or flossing. So "a mouthwash marketed for plaque removal may kill bacteria, but still wouldn't necessarily remove debris," she says.

Similarly, gum repair toothpaste — marketed to reduce the inflammation and gum bleeding that comes with gingivitis — contains the same active ingredient as most toothpastes: stannous fluoride, which has antibacterial properties. "Gum repair toothpaste may not work any better or differently than other toothpastes containing this type of fluoride," she says.

If in doubt, look for the American Dental Association (ADA) Seal of Acceptance on packaging. The seal means a team of dentists independently evaluated the product to verify that it says what it does and does what it says.

"I cannot tell the difference between patients' mouths based on the products they use," she says. "Really, it's just important to find a routine you can stick with. This is where product choice can be helpful; you can try different options and ultimately find something that enables you to maintain those good habits."

Additional revelations

What else might surprise you about dental health? Dr. Seymour offers six additional nuggets.

Brushing harder or longer isn't necessarily better. The choice of toothbrush bristle — or an electric variety — is personal preference, but a more abrasive brush doesn't make your pearly whites any whiter or your gums any healthier. As a rule of thumb, brush twice a day for at least two minutes. "It's more about technique than rigor," she says. "If your technique is effective, two minutes is just as effective as five." Ask your dentist for pointers on optimal brushing technique.

Flossing is optional, but cleaning between teeth isn't. Some people don't like dental floss, but that's not the only way to clean between teeth, where debris and plaque hide. Skipping this vital step can lead to inflamed gums and cavities. Floss-haters can try floss picks, which have tiny spans of floss stretched between plastic prongs. Other options include an oral irrigator (such as Waterpik) or an interdental cleaner, a tiny cylindrical brush. "The bottom line is, cleaning between teeth matters," Dr. Seymour says. "Ask any dentist if she can tell which patients do it and which don't — and we can."

Your dentist isn't only checking your teeth and gums—she's also screening for cancer. Dentists are trained to look for head and neck cancers during routine check-ups. This typically involves pressing around your jaw, chin, and neck to look for lumps or swollen lymph nodes. She'll also stretch your cheeks out and look at your tongue, palate, and throat for abnormal spots. Head and neck cancers affect 66,000 Americans each year, killing 15,000.

Going to the dentist when you're pregnant is recommended. A long-debunked but still-prevalent myth tells women to avoid dental care — and especially dental x-rays — while pregnant. But preventive care can nip a problem before it blossoms into an infection or a cavity requiring a root canal. Pregnancy also triggers many changes in the mouth, such as bleeding gums, that should be evaluated. "You need to be sure they're normal changes that will resolve after delivery or determine if they're signs that need more immediate attention," Dr. Seymour says.

Menopause can affect your mouth. The menopause-related drop in estrogen and progesterone can reduce saliva production, causing mouth dryness that encourages tooth decay and infection. Gum pain and inflammation (gingivitis) is also more prevalent when estrogen levels fall.

Chewing sugar-free gum can't substitute for brushing. Gum-chewing encourages saliva production, which helps wash away acids from foods and drinks before they can erode tooth enamel. Gum made with the artificial sweetener xylitol can enhance this effect, lowering the level of decay-causing bacteria in saliva. But these benefits don't override the value of twice-daily brushing. "Gum might dislodge large food particles, but it's not as effective at removing plaque as brushing," Dr. Seymour says.